Wow, so interesting learning more about health care options in the US. Living in Canada, although things are not perfect we have a system which provides pretty much everything my husband and I need in terms of health care at no cost at all, although we do pay for prescription drugs. At some point this will probably be subsidized for us too as our income drops further. I do feel very privileged to live where this is the case. Retirement would not be possible for us if we had to pay those costs you described. So glad you found a way to make things work. I understand your guilt about not wanting to have to use the ACA plan; but you have lived your life contributing to the world in a variety of ways and it is not your fault that the system in the US is what it is. (In fact even if you had not contributed it should still be there for you). Let that go; I am sure you have already. It is wonderful that it is available. That Concierge model sounds awesome too.